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Open Biopsy Of A Breast Lump

Massachusetts rates for HCPCS 19101

A surgeon makes a small incision in the breast and removes a piece of a lump or abnormal area so it can be examined under a microscope. Only part of the abnormality is taken, enough to reach a diagnosis, rather than the whole of it. It is used when needle sampling has not given a clear answer or when a larger piece of tissue is needed.

Rates data updated July 2026.

How much does Open Biopsy Of A Breast Lump cost?

$2,332

Typical total for the visit. In Massachusetts, July 2026.

Insurers have agreed to pay about $2,332 for this procedure. That total is two separate charges: $427 to the doctor who performs it, and $1,905 to the hospital or surgery center where it takes place. Done somewhere without a facility charge, you pay only the first.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 9 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$427$263 to $617
Facility feeThe hospital or surgery center$1,905$316 to $3,388

How much rates vary

Facilitymedian $1,905 · 10th to 90th $263 to $5,623Professionalmedian $427 · 10th to 90th $209 to $912
$200$500$1K$2K$5K$10K$20Kfacility $1,905professional $427

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$263.03
Median
$2,818.38
Typical High
$5,128.61
Aetna
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$275.42
Typical High
$851.14
AllWays Health Partners
Setting
Facility
Modifier
Global
Typical Low
$549.54
Median
$5,370.32
Typical High
$28,840.32
AllWays Health Partners
Setting
Professional
Modifier
Global
Typical Low
$223.87
Median
$416.87
Typical High
$1,023.29
BCBS
Setting
Facility
Modifier
Global
Typical Low
$263.03
Median
$263.03
Typical High
$602.56
BCBS
Setting
Professional
Modifier
Global
Typical Low
$380.19
Median
$562.34
Typical High
$831.76
Cigna
Setting
Professional
Modifier
Global
Typical Low
$302.00
Median
$501.19
Typical High
$933.25
Fallon Health
Setting
Facility
Modifier
Global
Typical Low
$239.88
Median
$331.13
Typical High
$3,630.78
Fallon Health
Setting
Professional
Modifier
Global
Typical Low
$398.11
Median
$489.78
Typical High
$691.83
Harvard Pilgrim
Setting
Facility
Modifier
Global
Typical Low
$2,041.74
Median
$4,265.80
Typical High
$9,772.37
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$263.03
Median
$436.52
Typical High
$912.01
Health New England
Setting
Facility
Modifier
Global
Typical Low
$1,905.46
Median
$2,511.89
Typical High
$4,365.16
Health New England
Setting
Professional
Modifier
Global
Typical Low
$229.09
Median
$575.44
Typical High
$691.83
Mass General Brigham
Setting
Facility
Modifier
Global
Typical Low
$549.54
Median
$5,370.32
Typical High
$28,840.32
Mass General Brigham
Setting
Professional
Modifier
Global
Typical Low
$223.87
Median
$416.87
Typical High
$1,023.29
United
Setting
Facility
Modifier
Global
Typical Low
$1,862.09
Median
$4,265.80
Typical High
$10,471.29
United
Setting
Professional
Modifier
Global
Typical Low
$263.03
Median
$478.63
Typical High
$954.99

Where Massachusetts sits

The same service costs 18.2 times more in Delaware than in Maryland. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Physician feeFacility fee

Massachusetts· 37th of 50

$2,332

$427 physician + $1,905 facility

DE $9,628MD $528

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.